Credentialing Specialist


Admin and Secretarial

Advert ID



Menomonee Falls

Job Type




Salary Range


No. of Openings


Branch Information

Wauwatosa, WI - (USA) 823 North Mayfair Road WI Wauwatosa , WI 53226



Job Description

What will YOU be doing for us?

Ensures organization meets all necessary requirements in credentialing and re-credentialing medical, dental, therapy, and vision providers according to client and NCQA guidelines.

What will YOU be working on?

Perform outreach to providers to obtain completed credentialing applications

Verify provider credentials according to product and quality guidelines for provider acquisition and re-credentialing.

Prepare provider files for review.

Ensure accuracy of provider information in credentialing portal by matching provider entered data with all credentialing documents.

Recommend system enhancements and process improvements.

Respond to provider inquiries related to the credentialing process

Assist with administrative duties as assigned.

Assist in annual NCQA accreditation process.

What qualifications do YOU need to have to be GOOD candidate?

Required Level of Education, Licenses, and/or Certificates

High school diploma/GED

Required Level of Experience

1+ years of experience in an office setting

Required Knowledge, Skills, and Abilities

Intermediate knowledge of Microsoft products including Word, Excel, and email

Strong typing skills

Ability to remain organized and meet multiple conflicting deadlines

Preferred Level of Education, License, and/or Certificates

Associates/2 year degree

Preferred Level of Experience

1-3 years of experience in a healthcare environment.

Provider Relations or Credentialing experience preferred.

Preferred Knowledge, Skills, and Abilities

Please submit your resume to be considered!